Children with predominantly inattentive ADHD (ADHD-PI, also known as ADD) have difficulties with social skills. These children tend to lack assertiveness and often have difficulty in social situations that require interactions with more than one person or with people they don’t know. Sometimes they struggle with a slow cognitive pace that can uncomfortably slow their response to social interactions. These children may also be perceived by their peers as self-centered and selfish because they may appear aloof as a result of their inattention.
The good news is that assertiveness and social skills can be taught. Extensive research has been done on teaching social skills to children with ADHD. Children with ADHD Combined type (ADHD-C) and ADHD Hyperactive Impulsive (ADHD-HI) need training in cooperation, self-control and empathy. Children with ADHD-PI need help with assertiveness, the appearance of easy and accessible communication. Studies have shown that social skills training is extremely effective in improving communication, assertiveness, empathy, and social interactions. More importantly, these studies have shown long-term benefits in improving the school experience of children with ADHD.
I found two studies that looked at social skills training in children with ADHD-PI. It appears that children with ADHD-PI receive more help from social skills training programs than children with ADHD of the mixed type or children with ADHD and comorbid oppositional defiant disorder.
The first study conducted on 59 children at Children’s Hospital-Boston found that children with ADHD-PI received more help with social skills training than children with the combined type of ADHD. The children received 8 weeks of social skills training, after which; “Children with ADHD-I improved in assertive skills more than children with ADHD-C.”
The second study is ongoing and is taking place at Berkley. Researchers at the University of California are conducting a longitudinal study of children with ADHD-PI. They are using a tool called the Child Life and Attention Skills Program (CLAS) to teach children and parents with ADHD-PI both attention skills and social skills. The researchers are still recruiting participants, but the first set of results, published a few years ago, concluded that; “Children randomized to the Child Life and Attention Skills Program were reported to have significantly fewer symptoms of inattention and slow cognition, and significantly improved social and organizational skills, relative to the control group.” If you live in the San Francisco area, you can contact the UC Berkley Department of Psychiatry here to participate in this study.
Children with ADHD are generally aware of social cues. They do not need to be taught to ‘read’ people’s reactions to them. Not being aware of social cues is one of the characteristics of children and adults with Asberger syndrome, but it is not usually a problem for children with ADHD. Children with ADHD-C and ADHD-HI have difficulties with self-control but are still aware of the social impression they are making. Children with ADHD-PI are often acutely aware of their social awkwardness and tend to avoid embarrassing situations.
Social skills training tools that have worked best for training children with ADHD include exercises that break down complex social situations into smaller components and train each component of social interaction one at a time. Role-playing is helpful, as is modeling, which involves the child looking at a model that exhibits the desired behavior. Social skills training is generally a family affair. Parents, siblings, and other family members are encouraged to participate in the training and role-play, encourage the children in training, and help reinforce the behaviors being trained.
In conclusion, social skills training has been shown to be extremely beneficial in improving the self-confidence and school experience of children with ADHD. This training can be especially helpful for children diagnosed with predominantly inattentive ADHD.
